What are our options for full-time care?

So the NH our mom is at for short term wants to discharge. She's under Medicaid. My place is on a second floor and isn't accessible for a walker. Also I'm not home between 7-4 and no I can't leave work as I already maxed out my family leave and am short hours to take another. The NH thinks she should not be left unsupervised, which I agree but still think it's a good idea to discharge her to my place. Yes she had been living with me. Difference is she was not physically handicapped. She could walk, use the restroom when she needed, bathe herself, dress herself, she'd walk to the park and do some yoga excercises and she could call me. She was a stroke survivor who became epileptic and thus could not drive so had to leave her job and could not afford her rent so she moved in. Now that she needs help with all this my place is no longer a safe option. The NH however won't recommend full time care because to them she only needs some assistance. Again who and how are they going to provide that some assistance. Anyone have any pointers on how to navigate this. When I told the NH SW that I can't take care of her due to time constraints she said it was my duty. Well if I don't work we're both on the street so how is that going to help matters. Also when I tell them she can come live with me when she is physically able to they tell me she might never get back to that point. When I said well if it's never what are her long term options. They said let's try two more weeks. Why try two more weeks of PT if you think she won't get better. It's very simple if she can get back to being able to walk and go up and down stairs she can live with me. If that is an absolute no go then she needs a more access friendly place.

No SW told me on the phone when she called to tell me they had a discharge date ready two weeks ago. She told my mom days after I gave her my reasons for not being able to bring her home. I think her plan though unprofessional was to see if she could convince my mom to go home. The ombudsman on the other hand asked her to do some tasks and then asked what she thought about going home. He didn't tell her, she could, should, or would. Which is the same as I had been doing. But it felt like the SW just assumed it was all my choice. When really the one not giving my mom a choice and voice was her.

Thank you all for the support and advice. I called the ombudsman and told him it was getting near to the additional 2 weeks that insurance is allegedly only going to pay and that I wasn't getting any support in creating a safe discharge. He went and talked to my mom. Mom told him about her fears, struggles, and limitations with going home. She also told him about how the lady (sw) had told her I needed to take care of her. He spoke with the SW who told him she wasn't thinking about discharge. I had shown him the insurance request for 2 weeks of care. So he pressed on about what happens after those 2 weeks because patient did not feel ready to go home. She told him she would have to get the doctors notes. This was all on Monday. Come home yesterday to find an approval from insurance for full time care the request having been made on Monday. Mom is happy that she doesn't have to worry about being alone. Or me spending out of pocket for her care. Both of which she shouldn't need to think on while she's working on recovery. But she is still a mom. She knows that if it came down to it I would quote my job and take care of her. But she said she doesn't want that for me. I'm glad they finally understood that mom and me are a team. I would not have forced her to stay had she wanted to go home, but she herself realizes she hasn't felt safer and wanted to know why she had to leave.

No worries GardenArtist. I think the SW however really thinks such things are possible. I don't want her to stay there long term. I'll be glad to leave that place in the past. But I need them to transfer her and not discharge her. Because if I take her home it's going to be a lot harder to get her into somewhere.

Yes stick to your guns. They need to find your mother safe housing. Out of the question that she can be discharged to your place. No, no, no.

Those SW need to get it moving and find placement. That is what they do. Make yourself clear in that there is no discharging her to your 2nd floor. Absolutely not. Physically impossible for her to even try.

I hope your mom finds a good place that she likes and it works out. Doesn't matter how long it takes, your mom isn't going anywhere until her needs are being met.

First, I think unfortunately that the SW and perhaps other staff at the rehab facility just aren't that interested in your mother's care; they have kind of a "not my job" attitude - just make sure their files are documented that she has a theoretically "safe" place and it's someone else's worry.

I saw that in the last place my father had rehab. They might also have taken less interest b/c I've heard they have their own AL associate company, but they couldn't convince him to consider AL placement. So they booted him out too early.

This rehab place used to be top notch, but it's gradually gone downhill. Now, it's the CYA attitude when it comes to discharges.

Few thoughts: can your mother stay on the first floor if you hire someone (like the small moving companies) to move her bed down? Equally as important, is there a bathroom on the first floor? Do you have a commode?

Get box fans for the first floor. They're quite powerful and can keep your mother cooler. Also find a good place for hand towels which can be moistened and placed across her head. Keep a hygrometer close by so you can monitor the humidity and heat levels (when you're home, of course).

I don't disagree with the others that you should put pressure on the staff, but the sad reality is that the balance of power isn't necessarily in your corner, and the anxiety must be frustrating for both you and your mother.

If her doctor will script for home care, that would help, but only partly and only for a while. In the meantime, start calling private duty companies to get extra help in while you're working. Ask the SW to give you lists of them as well as other facilities of a longer term nature which you can call and weed through to find some worthy of consideration. Then meet with them to discuss whether that would be a good facility for your mother to liv in.

I do agree to keep her at the facility as long as you can while you try to make other arrangements, but don't count on much help from the staff.

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